ABSTRACT
We evaluated the association between preventative social behaviour and government stringency. Additionally, we sought to evaluate the influence of additional factors including time, need to protect others (using the reported number of COVID-19 deaths as a surrogate measure) and reported confidence in government handling of the COVID-19 pandemic. We used repeated national cross-sectional surveys the UK over the course of 41 weeks from 1st April 2020 to January 28th, 2021, including a total of 38,092 participants. Preventative social behaviour and government stringency index scores were significantly associated on linear regression analyses (R2 =0.6468, p<0.001, and remained significant after controlling for the effect of reported COVID-19 deaths, confidence in government handling of the pandemic, and time (R2=0.898, p<0.001). Longitudinal data suggest that government stringency is an effective tool in promoting preventative social behaviour in the fight against COVID-19.
Subject(s)
COVID-19ABSTRACT
Objective: To examine the general publics views around willingness to receive COVID-19 vaccines and concerns regarding their safety. Design: Repeat cross-sectional surveys. Setting: Online surveys in Australia, Canada, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Singapore, South Korea, Spain, Sweden and the United Kingdom Participants: National samples of adults aged 18 years and above in November 2020 and January 2021. Main outcomes measures: The proportion of adults reporting: willingness to receive a COVID-19 vaccination; concern regarding side-effects from vaccinations; concerns over contraction COVID-19, and beliefs around vaccine provision in their country. Changes between the November and January surveys are also reported. Results: Across the 15 countries, the proportion of respondents reporting they would have the COVID-19 vaccine increased from 40.7% (range: 25.0-55.1) to 55.2% (range: 34.8-77.5), proportion reporting worried about the side-effects of vaccine decreased from 53.3% (range: 42.1-66.7) to 47.9% (range: 28.0-66.1). On the second survey, willingness to receive vaccine remained low in females (49.4%, range: 30.2-79.1), aged 18-39 years (42.1%, range: 25.9-71.7), those not working or unemployed (48.9, range: 18.8-67.0), students (45.9%, range: 22.8-70.0), and those with children at home (46.5%, range: 32.4-68.9). Concerns regarding safety of vaccine remained high in females (53.7%, range: 31.8-70.4), aged 18-39 years (50.8%, range: 28.2-60.7), aged 40-64 years (51.3%, range: 30.7-68.5), those working (50.5%, range: 26.7-65.0), those not working or unemployed (53.3, range: 35.4-73.8) and those with children at home (55.8%, range: 36.5-64.7). Conclusion: COVID-19 vaccine hesitancy decreased considerably over a relatively short time coinciding with the discovery of effective vaccines. The public remain concerned about their safety, and public health messaging will need to emphasis their safety especially amongst females, parents and younger adults.
Subject(s)
COVID-19ABSTRACT
ObjectivesTo determine the safety and effectiveness of home oximetry monitoring pathways safe for Covid-19 patients in the English NHS DesignThis was a retrospective, multi-site, observational study of home oximetry monitoring for patients with suspected or proven Covid-19 SettingThis study analysed patient data from four Covid-19 home oximetry pilot sites in North West London, Slough, South Tees and Watford across primary and secondary care settings. Participants1338 participants were enrolled in a home oximetry programme at one of the four pilot sites. Participants were excluded if primary care data and oxygen saturations are rest at enrolment were not available. 908 participants were included in the analysis. InterventionsHome oximetry monitoring was provided to participants with a known or suspected diagnosis of Covid-19. Participants were enrolled following attendance to accident and emergency departments, hospital admission or referral through primary care services. ResultsOf 908 patients enrolled into four different Covid-19 home oximetry programmes in England, 771 (84.9%) had oxygen saturations at rest of 95% or more, and 320 (35.2%) were under 65 years of age and without comorbidities. 52 (5.7%) presented to hospital and 28 (3.1%) died following enrolment, of which 14 (50%) had Covid-19 as a named cause of death. All-cause mortality was significantly higher in patients enrolled after admission to hospital (OR 8.70, 95% CI: 2.5 - 29.9), compared to those enrolled in primary care, Patients enrolled after hospital discharge (OR 0.31, 95% CI: 0.15 - 0.68) or emergency department presentation (OR 0.42, 95% CI: 0.20 - 0.89) were significantly less likely to present to hospital after enrolment than those enrolled in primary care. ConclusionsThis study find that home oximetry monitoring can be a safe pathway for Covid-19 patients; and indicates increases in risk to vulnerable groups and patients with oxygen saturations < 95% at enrolment, and in those enrolled on discharge from hospital. Findings from this evaluation have contributed to the national implementation of home oximetry across England, and further work will be undertaken to evaluate clinical effectiveness of the new pathway. Section 1: What is already known on this topicO_LIThe Covid-19 pandemic has created a new and significant burden on health systems globally. C_LIO_LIOxygen saturations have been found to be an important factor to stratify patient risk and guide treatment of Covid-19. C_LIO_LIHome oximetry programmes emerged during the early stages of the pandemic as an innovative means of monitoring patients with Covid-19 without admission to hospital. C_LI Section 2: What this study addsO_LIHome oximetry monitoring is associated with low rates of hospitalisation (5.7%) and all-cause mortality (3.1%). Many low-risk patients were enrolled in home oximetry pilots, and were associated with low rates of mortality. C_LIO_LIHome oximetry monitoring may represent a safe and programme for the delivery of community care to Covid-19 patients with pre-existing risk factors including increased age, high BMI and clinical comorbidities but who do not meet clinical thresholds for hospital admission. C_LI